Pregnancy in patients with a history of ischaemic heart disease-Case series and literature review [Grossesse chez les patientes ayant un antécédent de cardiopathie ischémique-Série de cas et revue de la littérature]
Matura-Bedouhene M.,University of Lorraine |
Maatouk A.,Service de Gynecologie obstetrique |
Maatouk A.,Center Hospitalier Saint Charles |
Moulin F.,Institute Lorrain du Coeur et des Vaisseaux |
And 5 more authors.
Journal de Gynecologie Obstetrique et Biologie de la Reproduction | Year: 2016
Heart diseases complicate 1 to 3% of pregnancies and are the leading cause ofindirect maternal deaths. Prior ischaemic heart event in pregnant patients is increasing. Mostknowledge is based on few reports and there are no French nor international recommendationsabout the specific management of these patients. The specificity of the management of thesepatients during pregnancy, delivery and post-partum depends on the severity of the prior cardiacevent and its consequences. This will be illustrated by the report of four recent cases managedin our hospital. First patient had myocardial infarction with normal left ventricular ejectionfraction (LVEF). Second patient had a Tako-Tsubo syndrome with LVEF 45%. Third patient hadischemic cardiopathy with LVEF 30%. Fourth patient had myocardial infarction with LVEF 20%.A multidisciplinary follow-up should be required, especially in patients with severe ventriculardysfunction. The risk of fetal growth restriction appears to be increased, suggesting that closerultrasound monitoring is necessary. © 2015 Elsevier Masson SAS.